RESUMEN
The author examines the patterns and predictors of newly emerging branch of science such as bioethics that originated on the background of a revolutionary situation in the history of biomedicine as the need for a new ethic that would confront the challenges brought about by scientific and technological development to humanity. Exploring many different kinds of bioethics issues, the author concludes that the essence of bioethics is that it is not only a scientific and practical discipline, but it is also a weltanschauung. Only with such an approach the spectrum of functions inherent in bioethics is expanded.
Asunto(s)
Discusiones Bioéticas , Bioética/tendencias , Georgia (República) , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Principios Morales , FilosofíaRESUMEN
During the last 10 years increase in the number of surgical centers developing the practice of off-pump heart surgeries has been noticed. Our medical centre, where 140 CABG surgeries have been performed, is one of the like. Such surgeries demand multicomponent anesthetic manual able to provide adequate depth of anesthesia, hemodynamic stability, prevention of intraoperative myocardial ischemia, providing an early patient activation in a postoperative period. On the assumption stated above we suggest and compare two anesthetic methods - total intravenous anesthesia on the basis of Propofol and Phentanylum and inhalational anesthesia on the basis of Isoflurane for providing CABG Surgery. It has been detected that the anesthetic methods offered by us enable to provide an adequate anesthetic defence while performing CABG Surgeries in case of stable markers of hemodynamics and oxygen transfer functions. Mild hemodynamic disorders have been detected in the operation course first of all at the expense of positional changes and heart immobilization. These disorders have not lead to the deterioration of oxygen transfer functions and have been totally eliminated in the recovery period. Worked-out anesthetic methods on the basis of Midazolam, Propofol, Isoflurane and low doses of Phentanylum (5-7 mcg/kg per hour) give a possibility to decrease the period of artificial lung ventilation, provides an early (less than 6 hours) and safe extubation for 86% of the patients and reduces their stay in a resuscitation unit as well.
Asunto(s)
Anestesia General/métodos , Anestesia Intravenosa/métodos , Anestésicos Intravenosos/administración & dosificación , Puente de Arteria Coronaria , Fentanilo/administración & dosificación , Propofol/administración & dosificación , Anciano , Femenino , Georgia (República) , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Oxígeno/metabolismoRESUMEN
The aim of the research was to determine the role of resuscitation science and practice in development of new trends in thanatology; and to determine the significance of integrated interdisciplinary approach to notion "death" as "biological, medical, and bioethical" categories. The author discusses nine distinct concepts of death and concludes that only complex scientific approach can enrich the knowledge about the notion of death. The list of different aspects of interdisciplinary bioethical definition of notion "death" was developed.
Asunto(s)
Bioética , Reanimación Cardiopulmonar , Enseñanza , Tanatología/historia , Actitud Frente a la Muerte , Muerte Encefálica , Historia del Siglo XX , HumanosRESUMEN
Considering beta-endorphin as a sign of tension and adaptation, the changes in its level have been studied during operations and surgery in patients with congenital heart valve defects subjected to cardiopulmonary bypass surgery. The goal of the study was determination of beta-endorphin concentration for the assessment of general anesthesia adequacy. A step-by-step study of beta-endorphin blood concentration, central and peripheral hemodynamics, diuresis, changes in temperature taken in 3 spots, adrenalin, dopamine and noradrenaline blood levels has been performed in 12 patients aged 4 to 17 years. A stable beta-endorphin blood content at all stages of anesthesia and surgery has been established. A correlation has been established between changes in adrenalin and dopamine blood levels, temperature gradient, diuresis intensity and mean BP, on the one hand, and changes in beta-endorphin blood level, on the other hand. Multifactor systemic analysis of the data obtained makes it possible to conclude that beta-endorphin blood level is informative when assessing the adequacy of general anesthesia.
Asunto(s)
Anestesia General , betaendorfina/sangre , Adolescente , Niño , Preescolar , Dopamina/sangre , Epinefrina/sangre , Análisis Factorial , Femenino , Cardiopatías Congénitas/cirugía , Hemodinámica , Homeostasis , Humanos , Masculino , Insuficiencia de la Válvula Mitral/cirugía , Norepinefrina/sangreRESUMEN
The relationship between the activities of the blood angiotensin-converting enzyme (ACE) and the site of the blood collection (radial artery, peripheral vein, left atrium) was examined in 15 patients with congenital heart diseases operated on with artificial circulation. No statistically significant differences in ACE activities in the blood from the vein, artery, or left atrium was detectable (p greater than 0.05). It is recommended that the blood for measuring ACE activity be collected from the peripheral vein.